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Posts Tagged ‘Healthcare’

Eat, Drink & Be Merry

We recently discussed the apparent contradiction between the facts that America is fatter than ever and people are living longer than ever. BMI is the determining factor in declaring Americans overweight.

However, the theory which says America should be suffering health problems and increased mortality because of increased obesity is quite wrong.

So why are death rates dropping and people living longer? Something must be wrong with the model — it’s pretty hard to quarrel with the data as being inadequate. Certainly the increased incidence of obesity should have produced something by this time (it started 30 years ago).

In case you have been living in a cave or something, there are several serious flaws with the BMI which make it unsuitable for determining health. A new German study by Matthias Lenz of the Faculty of Mathematics, Computer Science, and Natural Sciences of the University of Hamburg and his co-authors present these and other results in the current issue of Deutsches Ärtzeblatt International:

The Süddeutsche Zeitung published an advance notice of the report (http://www.sueddeutsche.de/gesundheit/140/489526/text/), which shows that overweight does not increase death rates, although obesity does increase them by 20%. As people grow older, obesity makes less and less difference.

For coronary heart disease, overweight increases risk by about 20% and obesity increases it by about 50%. On the other hand, a larger BMI is associated with a lower risk of bone and hip fracture.

In relation to cancer, the overall death rate among extremely obese men (BMI above 40) is no higher than among those of normal weight. Men who are overweight even have a 7% lower death rate. No significant association was found in women.

According to the authors’ analysis, overall mortality is unchanged by overweight, but increased by 20% by obesity, while extreme obesity raises it by up to 200%.

Futurepundit raises a few interesting points:

What I’m expecting: Genetic testing might show us what our relative risks are for a large variety of diseases and this knowledge could push us toward different ideal weights depending on which diseases we have the greater risks for. Also, some people are probably genetically better adapted to carrying more weight.

Note that you have other options for slowing bone decay aside from carrying more weight around. Exercise, better food, and a combination of vitamin D and vitamin K might cut bone fracture risks with age.

Weight studies are problematic because weight can vary due to muscle mass as well (albeit less often). Also, people can lose weight during the early stages of an illness before they even know they are sick. How well did the researchers adjust for these factors?

According to the CDC:

BMI is a fairly reliable indicator of body fatness for most people.

In light of this new study, will the CDC change it stance on using BMI data as a way of reliably gauging the health of Americans?

If the BMI chart is based on an illogical formula concocted over 200 years ago and can only give a general assessment of obesity in a population while failing on an individual level, why is it still in use by the government?

The answer is because government loves to create problems for which it is the solution. Pay close attention to what is happening here because this is a pattern that repeats over and over again.

We would not bet on it because it is not the first time nanny staters in the government have used bogus data to justify their agendas regardless of scientific truth, nor will it be the last. Rather than letting those busybodies get you down, learn how to eat your way to happiness. Being drunk and gassy is one recent formula for living a long life, although can easily be a life of bachelorhood if you are not careful to find the right wine/broccoli balance.

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There are many sad tales appearing on the internet which present people who are angry because they feel mistreated by their insurance company. Those personal anecdotes are designed to raise an individual’s ire and natural desire to do something about it. The reader may notice that conveniently attached to such stories are mentions of a solution to the problem: healthcare reform as being debated into law by Congress.

The setup seems almost too easy. David, the little man (or woman, or child, or family) gets beaten on by a Goliath (big insurance company) who treats them as mere numbers in a soulless quest for ever increasing profit, only to have Congress and others swoop in to save the day. Someone should create a comic book about that story because it would be entertaining – and fictional.

Yes, we are cynical and skeptical at heart and are willing to wager that many of our readers who come across such saccharine tales of heartache also immediately think “what are they selling?“. Being cynical and skeptical to a degree one notch below annoying is a trait commonly found in scientists because it is an important part of the scientific process. Not all of you are like that (yet), so for those of you who are new to all this, buckle up and hang on for an interesting ride.

Why would insurance companies do silly things, like deny coverage to an unusually heavy baby, if the bad publicity is so damaging to their reputation?

The answer is because insurance companies use statistical tables to make decisions, and anyone caught at the tail end will have a rough time. Here is the most interesting quote from the story of baby Alex Lange:

The frustrated parents said their child was the odd infant out in a cruel numbers game. A chart by the Centers for Disease Control and Prevention used by insurers puts Alex in the 99th percentile for weight and height for babies his age.

The BMI chart is an example of flawed statistics being used, but it is also not entirely inaccurate for a population wide assessment. In general, someone who has a BMI above 30 is far more likely to be unhealthy than to be an athlete. The problem is for those in the middle, in between normal and obese, who are merely considered overweight.

One flaw in the system is that while most people in the obese range are unhealthy, the same cannot be said for those in the overweight range. Pay close attention the next time you are at the park or the gym to those chunky guys who can outrun you. In fact, someone with low body fat who is athletic in that range between casual Frisbee player and professional athlete can often be classified as overweight.

Insurance companies can get away with using the BMI to classify people into broad categories, which then affects their premiums or if they are eligible for insurance at all because the government continues to use it, even though it is flawed. According to the CDC:

BMI is a fairly reliable indicator of body fatness for most people.

If the BMI chart is based on an illogical formula concocted over 200 years ago and can only give a general assessment of obesity in a population while failing on an individual level, why is it still in use by the government?

The answer is because government loves to create problems for which it is the solution. Pay close attention to what is happening here because this is a pattern that repeats over and over again.

First, the CDC called more than one million people between 2006 and 2008 and collected their information. The fact that the data are suspect because people routinely lie about their height and weight should be obvious even to a non-scientist. Second, after the data was gathered and processed, a conclusion was reached:

Experts believe there are several reasons for the differences. People with lower incomes often have less access to medical care, exercise facilities and more expensive, healthier food. In many places, minorities are disproportionately poor.

“Poverty is a very strong driver of obesity,” said Kelly Brownell, director of Yale University’s Rudd Center for Food Policy and Obesity

The differences being referred to are the differences between the African-American communities and other communities in terms of obesity. We already know the reason for those differences, and it is the reason the BMI chart is racist. So, where does that conclusion lead to?

The only way to deal with our “obesity epidemic” is to address the “poverty epidemic” — of course, as measured by yet another government psuedo-science statistic called the “poverty line”. And how do we deal with that? You guessed it, create more entitlement programs, programs to be run by the very same government that is funding the study, a study based on a statistical measure that is meaningless, where the statistics are unreliable and unverifiable but all point to the same convenient conclusion — the government needs more of your money.

And the media will now happily play along, running b-roll footage of some fat dude at Disney shoving ice cream in his pie hole or a fat mother and her fat kids waddling along through Frontierland, their butts bouncing up and down, as they stroll through the theme park in too-tight shorts and too-short t-shirts.

Laugh if you want but this is the same government that wants to ration your health care. Guess what? Fat people move to the back of the line under such a government-run health care system. Still laughing?

Although baby Alex Lange’s story inspires outrage, it is the insurance company taking all the heat, rather than the government. If the government banned the use of the BMI chart because of its flaws the insurance companies would be forced to evaluate everyone on an individual basis leading to fairer premiums. Individualized healthcare is one result of a market based system because a fair market needs to distinguish between a healthy 200 lb. person and a 200 lb. couch potato. Currently, they are both considered equally risky to insure and such a system does not foster individual responsibility.

People are even angrier today according to newspapers because a report which concluded that the healthcare reform bill recently approved by the senate finance committee would end up costing everyone more money is false – at least according to certain members of Congress and economist from MIT.

After an insurance industry report said that premiums would rise sharply with the passage of comprehensive health care legislation, Jon Gruber, a health care economist at the Massachusetts Institute of Technology, said he evaluated the report Monday at the request of Senate Democrats and found it deeply flawed.

Coming from a prestigious academic institution does not guarantee that Jon Gruber is telling the truth but it does lend him a lot of credibility, so he will be taken seriously. We are skeptics and our site is geared towards teaching non-scientists, so how can a non-expert determine if someone with fancy credentials is telling the truth when what they are saying goes against logic and common sense?

In this instance the answer is amazingly simple.

Mr. Gruber, who helped Massachusetts with its effort to provide universal health insurance coverage, said that the industry report failed to take into account administrative overhead costs that he said will “fall enormously” once insurance polices are sold through new government-regulated marketplaces, or exchanges.

We need to examine the situation in Massachusetts since they implemented universal health insurance in a way very similar to the proposals in the Baucus bill. Depending on how the situation turned out, it will either serve as a model for the current bills in Congress or a dire warning against them and will establish the reader establish Mr. Gruber’s real level of credibility.

The Wall Street Journal talks about the situation in Massachusetts (and other states, so go read the whole thing):

Guaranteed issue alone, the argument goes, results in slightly more expensive premiums, which drives healthier individuals out of the risk pool, which in turn further drives up premiums. The end result is that many healthy people opt out, leaving a small pool of sick individuals with very high premiums. An individual mandate, however, would spread those premium costs across a larger, healthier population, thus keeping premium costs down.

The experience of Massachusetts, which implemented an individual mandate in 2007, suggests otherwise. Health-insurance premiums in the Bay State have risen significantly faster than the national average, according to the Commonwealth Fund, a nonprofit health foundation. At an average of $13,788, the state’s family plans are now the nation’s most expensive. Meanwhile, insurance companies are planning additional double-digit hikes, “prompting many employers to reduce benefits and shift additional costs to workers” according to the Boston Globe.

And health-care costs have continued to grow rapidly. According to a Rand Corporation study this year, the growth now exceeds state GDP by 8%. The Boston Globe recently reported that state health-insurance commissioners are now worried that medical spending could push both employers and patients into bankruptcy, and may even threaten the system’s continued existence.

That certainly paints a cheery picture. There is more wonderful news from The Boston Globe:

The state’s major health insurers plan to raise premiums by about 10 percent next year, prompting many employers to reduce benefits and shift additional costs to workers.

Increases will range from 7 to 12 percent, capping a decade of consecutive double-digit premium increases, according to a Globe survey of the state’s top health insurers. Actual rates for 2010 will depend on the size of the employer and the type of coverage, with small businesses and individuals expected to be hit hardest. Overall, premiums are more than twice as high as they were 10 years ago.

The higher insurance costs undermine a key tenet of the state’s landmark health care law passed two years ago, as well as President Obama’s effort to overhaul health care. In addition to mandating insurance for most residents, the Massachusetts bill sought to rein in health care costs.

The failure of the Massachusetts system is far from hidden. Who is Jon Gruber hoping to fool by flashing his academic pedigree? Is the general population reading the news so incapable of examining the issues in any depth such that Mr. Gruber can brag about the wonderful state of universal health insurance in Massachusetts without the rubes bothering to check and see how things actually turned out?

Many newspapers and other outlets reporting on this situation are in favor of universal healthcare becoming law, damn the facts, and so reports on the subject tend to be biased by omission of key details which would entirely change the outcome of the story. The real anger is by citizens who are frustrated at being ignored by their elected officials and maligned by some members of the media.

When a layperson expounds about a subject in a way that it is clear they are out of their depth, we excuse the ignorance or quickly sniff out the agenda. However, we must hang our heads in shame when a fellow scientist abuses their position of trust and respect to mislead the general public. Jonathan Gruber’s motivation for lying is not important, simply because such lying is unacceptable. Studying science is about shedding light on the world’s mysteries, and so we have fulfilled our responsibility by illuminating this situation with sunlight, the best disinfectant.

Exit question: What are you going to do about it?

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UPDATE: See below, at the end of the article.

The Wall Street Journal reports that the Senate finance committee has approved a healthcare reform bill today.

The vote was 14-9, with Sen. Olympia Snowe of Maine the only Republican to join the 13 Democrats on the panel. Ms. Snowe indicated earlier in the day that she would support the measure.

The Senate Finance panel, led by Chairman Max Baucus, becomes the last of five congressional panels to act on a health-overhaul bill, and it marks the biggest step forward yet for President Barack Obama’s top domestic priority. The Baucus-proposed 10-year, $829 billion plan would require all Americans to purchase insurance and aims to hold down spiraling medical costs over the long term.

The legislation that passed the other House and Senate committees did so without a single Republican vote.

Unfortunately for Congress, a non-partisan report has come to the conclusion that costs will go up if the proposed legislation is made into law.

On Monday, insurers ratcheted up concerns about the sweeping Finance Commitee bill. A report released Monday by America’s Health Insurance Plans, an industry trade group, said the Finance bill would impose stiff costs on consumers. Among other things, the report said a family health-insurance policy that costs $12,300 today would increase to $25,900 on average by 2019 under the bill, more than under current law.

The analysis in the report was conducted by PriceWaterhouseCoopers, certainly not a slacker, no-name entity without a reputation for accuracy on the line. Even though they did not release the underlying statistical data with the report, it does not take an advanced degree to understand the logical problems inherent in the bill’s design.

PWC is stating the issue politely, to say the least. What is meant by a “weak mandate” is that, in the current version of the Baucus bill, there is no requirement to buy health insurance at all until after 2013, and by 2017 the penalty for failing to buy health insurance still amounts to only about 15% of the cost of the insurance. Now, think about it: if you know that you don’t have to buy health insurance when you are young and healthy, but if you should get sick, or just get older, you can apply for health insurance at any time and it will be illegal for the insurance company to turn you down, what would you do? Obviously, you would defer buying insurance unless and until you get sick. This means that the pool of those who are insured will be lower quality, and the cost therefore higher for everyone who buys insurance. It is as though you could wait until you die, and then your heirs can buy life insurance on you.

This isn’t reform, it is stupidity.

Trying to force everyone to have health insurance in the manner proposed by this bill may technically solve the problem of millions of Americans being uninsured. It is also logically impossible to do so without lowering quality, increasing costs, or both.

Some people are skeptical, so we will present a current example to prove the point. In this case we will examine the healthcare system in Massachusetts.

So let’s look at the closest model we have for this system in the United States:  the state of Massachusetts.  Massachusetts has all the goodies in the Baucus bill:  subsidies, guaranteed issue, community rating, an individual mandate, and employer penalties.  Indeed, the Massachusetts program is probably to the left of where we’re going to end up, on things like empowering the exchanges to negotiate with insurance companies and the size of the penalties for failing to procure insurance, two measures which are supposed to be critical for holding costs down.

Instead, costs have exploded.

Go take a look, they have a few charts up and detailed analysis of the cost increases. This whole sordid affair raises plenty of good questions:

So I’ll turn it around on reformers:  why do you think that we can control costs, given that we couldn’t at the state level?  Massachusetts is a very liberal state, a very rich state, and it started out with a relatively low proportion of its citizenry uninsured.  Proponents of reform often say it has to be done at a national level because states can’t borrow money in downturns, but this doesn’t explain why the spending side is headed through the roof.

Some people would say that Congress is choosing the complicated and expensive way versus the simple and cheap way because the former presents opportunities for graft, unlike the latter. Here is one such simple reform idea:

All we have to do is allow insurance companies to compete nationally instead of state-by-state and eliminate all mandates that limit consumer choice. It has been estimated that these simple reforms–which are not part of any of the Democrats’ “reform” bills, for obvious reasons–would reduce health care costs by one-quarter to one-third. Instead of such common-sense reforms, the Dems are proposing Rube Goldberg measures that will make health care more expensive. Instead of eliminating mandates, their measures, including the Baucus bill, increase them–in effect making cheaper health insurance illegal.Once more: this isn’t reform, it is stupidity.

Thanks to the power of the internet you can now fax senators about the healthcare reform bill and let them know what you think. Now is a great time to let your voice be heard.

It’s important that this blast fax campaign reaches every citizen who is opposed to this irresponsible legislation, especially in the states of MT, IN, AK, CO, PA, ND, NC, SD, AR, FL, PA, VA, MO, UT, IA, NH, ME and OH. Our best chance to stop this government healthcare takeover is to let our legislators know, whether they are home or in Washington, we are watching closely.

The Washington Examiner has an interesting two part op-ed discussing The Truth About The Baucus Bill (Part one, part two):

There is another reason why the CBO’s preliminary analysis should be taken with a grain of salt, though this one wasn’t mentioned in the report. Whatever the content of the Baucus bill once it is voted out of the finance committee, it will disappear into a legislative black hole as Senate Majority Leader Harry Reid, House Speaker Nancy Pelosi, and their key aides do what they did on the economic stimulus package back in February — huddle together behind closed doors to write the final bill, which will then be presented as a fait accompli in the form of a conference report.

Governor Tim Pawlenty (R-MN) clearly shows that the bill being brought forth is strange because there are good ideas for reform being ignored. He also lays to rest the popular misconception that there are no good ideas for healthcare reform being suggested other than what is present in the current bill:

There are many bipartisan ideas that would actually cut health care costs, like medical liability reform, allowing employees to keep their insurance when they switch jobs, standardizing health information technology, and allowing consumers to purchase insurance across state lines.  In Minnesota, we’ve passed reforms that made price and quality more transparent for patients, moving the health care system towards paying for and achieving better health care outcomes, and empowering patients themselves to help drive down costs.

You can read here how Governor Pawlenty is implementing those ideas for healthcare reform right now in Minnesota. Although we are proud of Governor Pawlenty putting his money where his mouth is on healthcare reform, we are not comfortable with him promoting creationism in public schools.

MR. BROKAW: In the vast scientific community, do you think that Creationism has the same weight as evolution, and at a time in American education when we are in a crisis when it comes to science, that there ought to be parallel tracks for Creationism versus evolution in the teaching?

GOV. PAWLENTY: In the scientific community, it seems like intelligent design is dismissed — not entirely, there are a lot of scientists who would make the case that it is appropriate to be taught and appropriate to be demonstrated, but in terms of the curriculum in the schools in Minnesota, we’ve taken the approach that that’s a local decision. I know Senator Palin — or Governor Palin — has said intelligent design is something that she thinks should be taught along with evolution in the schools, and I think that’s appropriate. My personal view is that’s a local decision —

MR. BROKAW: Given equal weight.

GOV. PAWLENTY: — of the local school board.

MR. BROKAW: And you would recommend it be given equal weight?

GOV. PAWLENTY: We’ve said in Minnesota, in my view, this is a local decision. Intelligent design is something that, in my view, is plausible and credible and something that I personally believe in but, more importantly, from an educational and scientific standpoint, it should be decided by local school boards at the local school district level.

In conclusion, as we have discussed here before at length, there are many very good ideas for healthcare reform which should be given a chance to succeed, especially because mandatory government healthcare runs contrary to American principles of liberty. As always, when it comes to Congress (or any government officials for that matter) judge them based on their actions, not their words. Ok, sometimes by their words.

UPDATE: Recent news reports are publicizing claims by MIT economist Jon Gruber that the PWC report is false. Unfortunately, Mr. Gruber is lying. We discuss the issue at length here.

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Steven Perlstein has a good article in The Washington Post explaining some of the problems with health insurance as it exists today.

There is a part of health insurance that is meant to protect us from unpredictable or unavoidable “catastrophes,” such as getting cancer or having a heart attack. But there is also a part of health insurance that covers fairly predictable and routine medical expenses — the annual physical, a kid’s ear infection or a colonoscopy for a 55-year-old. In those cases, health insurance is not so much protection from catastrophe as it is a mechanism to “prepay” what is likely to be the bill for your own care.

Simply giving people more insurance without addressing the fundamental issues in the existing system is precisely the reason we feel Congress is not serious about reforming healthcare.

Here are a few other interesting points he discusses:

Then there are those who are demanding that Medicare pay more to doctors and hospitals in areas with high medical costs. In reality, this is nothing more than requiring the rest of us to subsidize the inefficient lifestyles and cost structures in rural communities and big cities.

Those who want to prohibit insurance companies from charging higher premiums to people who smoke, drink heavily, abuse drugs or have unhealthy diets apparently take the position that these behaviors should be subsidized by those who take better care of their health.

And those who rail against limits to end-of-life care are effectively saying that patients willing to follow the best medical evidence about what works and what is cost-effective should be required to subsidize those who don’t.

In a free country, people have the right to decide what to buy, where to live, what to eat and drink, and how much medical care to buy. They’re even free to negotiate for health benefits instead of wage increases. What they don’t have is the right to expect that everyone else should pay for their choices through higher taxes and higher health insurance premiums.

People respond to incentives. If regular, planned treatment continues to get covered by insurance (like using insurance to pay for groceries) then prices will remain high, unevenly distributed and opaque. If there is no penalty for making poor choices, then poor choices will abound.

Go read the whole thing.

Over a year ago Bill Whittle wrote an excellent essay which explains why government healthcare (especially in guise of the “public option”) is a terrible blow against freedom.

There’s a scene in Bowling For Columbine where Michael Moore interviews a typically decent and friendly Canadian as he emerges from a health clinic. The poor fellow had, as I recall, some serious injury, and Mssr. Moore wanted to know what it had cost him for treatment.

The man couldn’t reply. They hadn’t charged him. This took Michael Moore’s carefully rehearsed breath away! No charge? You mean, you got that medical attention for free?

That’s right, eh.

Cut to beatific look on directors face, as if he had just been handed a clean plate at a Shoney’s Breakfast Bar.

Folks, Canadians are great people. They are not a stupid people. So can we not, please, not ever again, call this Free Health Care? It is Pre-paid Health Care. That Canadian fellow paid for that treatment every week, for the past twenty years. It was taken out of every paycheck he made. He paid for that medical care, and much, much more. He paid for it whether he needed it or not. And he not only paid for the doctor, he paid for the bureaucrats and administrators in the National Health Service or whatever it’s called. It was not free. It was paid for. Whether he needed it or not. When he has fully recovered, years from now, he will still be paying for it. Every week, from every check. That car or vacation he couldn’t afford, got eaten up by health care he paid for but did not need.

So the question is, who better decides what kind of health care you and your family need: you, or Hillary Clinton? I understand that not all poor people can afford health insurance. Again, being a decent sort of fellow beneath my strikingly handsome exterior, I don’t mind paying a little extra for Medicare for people who need help. I can even live with my insurance rates being higher to cover the cost of caring for the uninsured at the Emergency Room.

But! What I most assuredly DO NOT need is for someone taking my money to give me a health care system I do not need or want. As my all-time idol P.J. O’Rourke once said, if you think health care is expensive now, just wait till you see what it costs when it’s free.

This is a great example of the seduction of the state, because “Free Health Care” sounds like a great deal. It’s Caring! It’s Healthy! And it’s Free!

It’s not free. And not only do I object to being told what I need and don’t need, I also object to the idea that some dim-witted Student Council dork thinks he knows what’s better for me than I do.

P.J. Again: if you think that Public is an altar to worship at, put the word “public” in front of these words and tell me how you feel: Restroom. Swimming pool. Transportation. Here’s another: Take the words Decision, Officer, Appointment, and then add the word “political” to the front end and watch them drop in value.

So, look around. Look at how people feel about government, and ask yourself, does this or that person think of themselves as an adult or as a helpless child? Freedom is not for children. Freedom means responsibility. It means making tough decisions yourself. Freedom is not government. Almost all government is the enemy of freedom; the bigger the government, the more powerful the enemy.

This is an excerpt from a longer essay which makes several other worthwhile points, so go read the whole thing.

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Eric at Classical Values brings up an interesting point – veterinary care is a pretty good example of the free market at work in a healthcare system.

Under our “system” of veterinary health care, there’s generally little or no wait, they’re invariably friendly (because you could always grab your dog or cat and take it to another vet), and as to the prices?

He gives a personal example involving a visit to the vet for his dog which actually cost $950, whereas a comparable operation on a person would likely cost upwards of $20,000. It is possible to quibble about the details, but undoubtedly the same operation on person would cost many times more.

Differences in liability insurance is part of it. Bear in mind that it is more difficult to get into veterinary school than medical school.

It strikes me that there is a giant, overarching difference between veterinary care and regular medical care, and that is that the former is barely regulated by the government, while the latter is so regulated that even now — without socialized health care — many doctors feel as if they spent most of their time being bureaucrats. Is that it? I’m sure my vet kept records for Puff, but I’d be willing to bet they consisted of little more than a couple of paragraphs summarizing the diagnosis, the procedure, and his recovery. And I’d also be willing to bet that for the same procedure on a boy, if all of the records were all printed out they’d be a stack of documents inches thick.

The bureaucracy adds to the costs in many different ways, from ordering unnecessary tests to increased personnel costs merely to deal with mountains of paperwork. The lack of tort reform with regards to medical malpractice insurance is also responsible for a large portion of the higher costs.

While I realize technology has added many tools to the medical arsenal since the 1940s, the same tools have been added to the veterinary arsenal, so that can’t be all there is to it. I have not seen any vet bills from the 1940s, but I am sure that a cursory examination would reveal that the rate of increase has risen in a normal manner that we would expect, while the rate of increase for human medical care has skyrocketed. (Of course, in those days, far fewer people had health insurance. Might the “blank check” from the big pocket have something to do with it?)

Should we allow vets to treat humans? Why not? If a woman can consent to an abortion, why can’t I consent to having a veterinarian cut a tennis ball out of my intestines?

Why can’t we be consenting adults?

As long as members of Congress remain cozy with trial lawyers, tort reform will not be implemented. Please note that simple things can be written into law which would have an effect on the system without drastically overhauling it in the worst way possible. For example, when we hear that there are potentially billions of dollars being wasted in Medicare/Medicaid programs, why wouldn’t that get taken care of immediately and independently of any healthcare reform bill?

There are viable solutions. Unfortunately recent current events such as the problems with ACORN[1] and the NEA[2] only further the notion in most citizens minds that more government is very clearly not the answer.

[1] In case you’ve been living under a rock, ACORN is under fire for promoting child prostitution. They’ve received millions of federal dollars.

[2] The NEA is in trouble, having been caught allowing the White House to push a partisan agenda during a conference call, which is very likely against the law.

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Bundling services, such as having television, telephone, and internet from a single provider can be cost effective. However, should a problem occur all services may be lost simultaneously. Serious professionals who work from home will often have internet service from two different sources (one from the local telco, one from the local cable company) so they are never stuck with an outage.

Here are a few cases from England which show how bundling, in this case having government in charge of both healthcare and social services, is a recipe for disaster.

Case # 1:

The mother of a 13-year-old girl who became partly paralysed after being given a cervical cancer vaccination says social workers have told her the child may be removed if she (the mother) continues to link her condition with the vaccination.

Case # 2:

A couple had all six of their children removed from their care after they disputed the necessity of an invasive medical test on their eldest daughter. Doctors, who suspected she might have had a blood disease, called for social services to obtain an emergency protection order, although it was subsequently confirmed that she was not suffering from the condition. The parents were still considered unstable, and all their children were taken from them.

Case # 3:

A single mother whose teenage son is terminally ill and confined to a wheelchair has been told he is to become the subject of a care order after she complained that her local authority’s failure to provide bathroom facilities for him has left her struggling to maintain sanitary standards.

These problems have gotten the attention of at least some politicians.

John Hemming, a Liberal Democrat MP, who campaigns to stop injustices in the family court, said: “Very often care proceedings are used as retaliation by local authorities against ‘uppity’ people who question the system.”

Read all the details on the cases here.

An important fact worth understanding clearly when reading about these cases is the fact that a significant majority of the people who receive healthcare services in England are happy with the care they get. However, the small minority which suffers mistreatment at the hands of this system have no recourse.

Healthcare in the United States needs to be reformed, and there are plenty of excellent ways to do so which do not require more government – in fact, they require the opposite. The “public option”, which is a front for pushing a single payer system, does nothing to address the underlying fundamental problems with healthcare as it exists today, and will open up the system to abuses of the kind now being perpetrated in England.

Offering many more people “free” health insurance does not equal healthcare reform.

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The Center for Disease Control released new data for 2007 (based on 90% of all USA death certificiates) showing that mortality rates dropped again (by over 2%) to 760/100,000 population. It’s been dropping for the past 8 years, and viewed longer term is half of what it was 60 years ago. Interestingly death rates from heart disease dropped a staggering 5% and even cancer dropped 2%.

We consider that factual information to be good news, yet we are faced with a contradiction here because America is fatter than ever.

We are told to be prepared for an epidemic of diabetes, high blood pressure, elevated blood lipids because of this. Every doc has seen blood sugar drop, blood pressure lowered, lipids come down in people with any/all of the above when they are able to lose a significant amount of weight.

However, the theory which says America should be suffering health problems and increased mortality because of increased obesity is quite wrong.

So why are death rates dropping and people living longer? Something must be wrong with the model — it’s pretty hard to quarrel with the data as being inadequate. Certainly the increased incidence of obesity should have produced something by this time (it started 30 years ago).

It is an interesting question, and a few ideas are proposed. This is not an exhaustive list by any means.

  • People may be in engaging in more/ higher quality exercise.
  • Fewer people are regular smokers.
  • Better, more well informed doctors.
  • Better drugs on the market.

We are not the only ones to notice the bogus nature of the BMI, and some other people have proposed alternatives based on the fact that a group of people of equal height and weight can have very different mortality rates.

Also, when taking into account people who are skinny because they smoke a lot, there is still no indication that being overweight increases mortality.

Linking, for the first time, causes of death to specific weights, they report that overweight people have a lower death rate because they are much less likely to die from a grab bag of diseases that includes Alzheimer’s and Parkinson’s, infections and lung disease. And that lower risk is not counteracted by increased risks of dying from any other disease, including cancer, diabetes or heart disease.

The BMI is bogus. It bears repeating again and again because we still live in a system which judges your health, and thereby your insurance premiums based on this nonsense. Private insurance companies can be mandated to change this by Congress but the CDC and others enjoy the convenience provided by simply using national BMI data.

If the government is using statistically invalid data to judge the health of Americans, can we trust them with actually running the healthcare system? Why should we trust a proposed system of hugely increased cost and responsibilities by officials who can’t bother getting the basic things right?

Many public officials have been holding town hall meetings recently to try and sell the proposed healthcare legislation to the public. Take a few moments and read this compilation of important questions which need to be answered by the President and Congress before any healthcare reform bill gets voted into law.

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Matt Holzmann explains in The Banality of Evil how the president and congressional leadership have lowered the mask and reveal that the various healthcare reform bills being circulated have nothing to do with fixing the healthcare system in the United States at all.

Somewhere far removed,  bureaucrats make life and death decisions based on the numbers. With all of its faults, our current system values life much more highly. One of the chief theoreticians they seem to be listening to, Dr. Ezekiel Emmanuel, the White House Chief of Staff’s brother, has openly discussed the “life value” of infants and the elderly, noting that a child is not really self aware until the age of two. This is a very, very dangerous discussion.

There are those who see governmental control over healthcare as a positive thing. Perhaps they are selfish and view a situation in which someone else is paying for their healthcare as worth supporting. It is also possible that some people view the need for universal coverage as a strong moral cause well worth championing.

One of the fundamental virtues Americans have always held is the value of life. Whether it is in the care for sick infants or the billions spent on AIDS research or the heroic measures in the operating room on an inner city gunshot victim, or on the battlefield where our troops are indoctrinated with “no man left behind”, or our fundamental obligation under Medicare for the care of our elders,  we have almost always managed to do the right thing. We make herculean efforts to do so. There is a preferential option for the weak in our culture that we must never lose that is based upon our humanity and our faith.

Unfortunately, supporters of universal government healthcare are quite wrong. The ideal of universal coverage is quickly lost in the harsh reality of finite budgets.

The laws of our country governing commerce are made by a group of individuals who have never run a business, never met a payroll, have trouble with taxes and who consider major ethical violations to be unworthy of serious inquiry – and that is aside from the mysterious way in which they leave office as multi-millionares on a government salary. (Someone should write a book or something.) Thus far, they have managed to worsen the economy and lower their value in the eyes of the public to record depths.

Putting that motley crew in charge of the healthcare decisions of millions of Americans would be far worse than doing absolutely nothing. It is not as though critics have failed to offer concrete solutions which can fix our system. The fault, it seems, is that the solutions would give government less control and if a system cannot be taken advantage of to create jobs for cronies or for graft it hardly seems likely to get made into law.

The most damning argument is one of principle. The United Stated was founded on principle of liberty and in opposition to tyranny. We should keep those principles in mind in an important discussion of this magnitude.

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In an op-ed in The Washington Post, Charles Krauthammer mentions two ideas for reforming healthcare in America. One of them should be familiar to our regular readers, and the other is new and deserves special mention.

If you are new here, read Markets, Not Mandates to get up to speed. There, the idea of eliminating employer provided health insurance is discussed and even more reasons for doing so are covered in the op-ed.

Health insurance premiums will always be haunted by medical malpractice lawsuits and awards unless Congress enacts serious tort reform. Costs are raised because doctors have more bills to cover in the form of higher malpractice insurance premiums and also because of unnecessary tests and procedures which get performed as part of “defensive medicine”. Those higher costs get passed along to you.

Now, the good news: there is a solution.

What to do? Abolish the entire medical-malpractice system. Create a new social pool from which people injured in medical errors or accidents can draw. The adjudication would be done by medical experts, not lay juries giving away lottery prizes at the behest of the liquid-tongued John Edwardses who pocket a third of the proceeds.

The pool would be funded by a relatively small tax on all health-insurance premiums. Socialize the risk; cut out the trial lawyers. Would that immunize doctors from carelessness or negligence? No. The penalty would be losing your medical license. There is no more serious deterrent than forfeiting a decade of intensive medical training and the livelihood that comes with it.

We support this idea.

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Why The BMI Is Bogus: A Top 10

We’ve already discussed the reasons the BMI index is stupid and racist. In light of our earlier post, here is a top 10 list of reasons the BMI index is bogus.

  1. The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.
  2. It is scientifically nonsensical.
  3. It is physiologically wrong.
  4. It gets the logic wrong.
  5. It’s bad statistics.
  6. It is lying by scientific authority.
  7. It suggests there are distinct categories of underweight, ideal, overweight and obese, with sharp boundaries that hinge on a decimal place.
  8. It makes the more cynical members of society suspect that the medical insurance industry lobbies for the continued use of the BMI to keep their profits high.
  9. Continued reliance on the BMI means doctors don’t feel the need to use one of the more scientifically sound methods that are available to measure obesity levels.
  10. It embarrasses the U.S.

Everything on this list has extra interesting details, but in order to see them you will need to check out the source.

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The Hoover Digest has compiled a top 10 list of reasons the health care system in America is actually in pretty good shape and cautions against government intervention. There are many misconceptions and half rumors being spread around the internet about the state of healthcare in the United States.

Here is a summary version of the list. Go to the Hoover Digest to read all the details on each item.

  1. Americans have better survival rates than Europeans for common cancers.
  2. Americans have lower cancer mortality rates than Canadians.
  3. Americans have better access to treatment for chronic diseases than patients in other developed countries.
  4. Americans have better access to preventive cancer screening than Canadians.
  5. Lower-income Americans are in better health than comparable Canadians.
  6. Americans spend less time waiting for care than patients in Canada and the United Kingdom.
  7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
  8. Americans are more satisfied with the care they receive than Canadians.
  9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain.
  10. Americans are responsible for the vast majority of all health care innovations.

Some members of Congress and President Obama are eager to pass some kind of healthcare reform legislation which will expand the role of government. The question is, are they looking for a solution to a problem that doesn’t exist?

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The MC1R (melanocortin-1 receptor) gene produces melanin in humans. A variant of this gene present in redheads may be responsible for an increased sensitivity to pain. Non-redheads may carry this variant nor is it 100% guaranteed that a redhead will have it.

Many people will encounter anesthesia for the first time in their everyday lives at the dentist’s office. Administering too much anesthesia can have serious consequences so dentists are hesitant to go above recommended guidelines. Someone with a heightened pain sensitivity will likely never want to set foot in a dental office again after single procedure requiring anesthesia. Postponing dental care will likely make the problem worse and cause even more pain down the road.

“Redheads are sensitive to pain,” said Dr. Daniel Sessler, an Outcomes Research Department chair at The Cleveland Clinic, in Cleveland, Ohio, who is one of the authors.

“They require more generalized anesthesia, localized anesthesia. The conventional doses fail. They have bad experiences at the dentist and because of the bad experiences, they could avoid dental care.”

Sessler, an anesthesiologist, began studying redheads’ sensitivity to pain after hearing chatter from colleagues.

“The persistent rumor in the anesthesia community was that redheads were difficult to anesthetize,” Sessler said. “They didn’t go under, had a lot of pain, didn’t respond well to anesthesia. Urban legends usually don’t start studies, but it was such an intriguing observation.”

This led to two studies. In 2004, research showed that people with red hair need 20 percent more general anesthesia than blonds and brunettes.

A 2005 study indicated that redheads are more sensitive to thermal pain and are more resistant to the effects of local anesthesia.

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This is a serious question with serious implications for your personal health and the health of the economy. One of the things that make asking a question like this difficult is that politics and politicians elicit lunatics from all areas to spew unsourced and unhinged conspiracy theories on the internet.

Go read Markets, Not Mandates to bring yourself up to speed about ways Congress can improve health care in The United States by fixing fundamental problems which currently exist in the system as it is set up now. Thus far, every idea being pushed as potential legislation would make the situation worse.

“The Public Option” is one idea being put forward to help those who don’t have or can’t get health insurance. Although it sounds reasonable on its surface, many are accusing it of serving as a trojan horse for a complete government takeover of health care, via a single payer system.

Here’s where we stand today: there are important government officials, such as President Obama, who are claiming that a single payer system is not their intent with current legislation, and that nothing could be further from the truth. We also have this video compiled by NakedEmperorNews detailing several important officials, including President Obama, detailing their desire for government run, single payer health care.

Watch the video, and witness it for yourself.

A government run single payer system would destroy the private insurance market and force almost everyone to rely on the government for health care. Imagine a system with the efficiency of the DMV (Department of Motor Vehicles) and the compassion of the IRS (Internal Revenue Service). The exceptions are wealthy individuals who can afford to pay doctors in cash, such as Congressmen.

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First, the bad news: it is extremely unlikely that Congress will get health care reform right.

The good news: with sufficient pressure from you, citizen taxpayer, Congress may at least end up pointing in the right direction.

There are three factors which will create a fair market for health care products and services.

  1. Consumers – most people get health insurance from work. It causes a major market distortion for everyone else.
  2. Transparency – prices need to be easily accessible by the public for easy comparisons, otherwise there is no real market.
  3. Competitiveness – Doctors will compete for business in a real market place.

Employer based insurance must end. Instead, insurance needs to become what it is in every other market – something to deal with catastrophic, unforeseen circumstances.

Harvard University business professor Regina Herzlinger is stuck in exactly the same place as most Americans—her employer, in this case, the president of Harvard, buys her health insurance for her. “I wouldn’t permit him to buy my house or my clothing or my food for me. Yet as my employer, he could take up to $15,000 of my sala­ry each year and buy my health insurance for me, without knowing anything about my preferences or needs. It’s ridiculous.” Indeed it is.

Paying for an annual checkup with insurance is as silly as paying for groceries with insurance. There will be something for everyone, much like shopping for groceries. Some people go to Whole Foods, some to the local Walmart.

Cost-conscious general contracters exist in the housing market because of consumer demand, not government mandate. Similarly, consumer choices have driven the housing market to create the huge variety of options including high-rise condos, gated communities, rental apartments, manufactured housing, townhouses, and suburbs filled with ranch houses, Tudors, and Cape Cods. Competition in medicine would force physicians, hospitals, pharmaceutical companies, and other practitioners to figure out ways to reduce costs. Perhaps a medical general contractor model would prove most effective at lowering costs, but why not let some people go a different route?

Government run programs like Medicaid, SCHIP, and Medicare should be shut down. Right now they distort the market by underpaying doctors for some procedures, who in turn must charge private insurance companies more to make up the difference. Instead, the government can issue vouchers to the poor who may then use them to purchase medical care from the private market.

Read the whole thing.

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Congress has apparently been considering a “Bo-Tax” on cosmetic surgeries. It should come as no surprise to anyone who pays attention to politics that the average person undergoing such a procedure is not a wealthy socialite, and the idea that this would be a tax on the rich is ridiculous.

Roth, a plastic surgeon at Maimonides Medical Center in Brooklyn, N.Y., said it “would be a discriminatory tax against women,” noting that 86 percent of patients are female and 91 percent are of working age between 19 and 64.

He also disputed the notion it would be a “tax on the wealthy,” noting most patients earn less than $100,000 a year. “People put money aside for years, sometimes weekly under-the-mattress deductions” to get the surgery they want, he said.

If it is permissible for Congress to tax particular medical procedure, then what’s preventing a special tax on abortions? How much meddling in private affairs are citizens willing to put up with before it becomes too much?

…Susan R. Estrich and Kathleen M. Sullivan have stated: “Whatever position one takes on the decision to [publicly fund abortions], it is surely different than a state policy which seeks to ‘encourage childbirth’ by taxing abortion. Even assuming that rewards may be appropriate to secure the end of childbirth, punishments should not.”

Legally, it seems the government is allowed to levy a tax as long as it doesn’t impose a substantial burden.

…under current law, a tax targeted at abortions would be difficult to sustain. Under Casey, states may not impose regulations that place an “undue burden” on a woman’s constitutional right to terminate her pregnancy. A law creates an “undue burden” where it has “the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.” Any abortion tax large enough to raise a meaningful amount of revenue would likely increase the cost of abortions sufficiently to constitute an “undue burden” under this test.

In other words, if the tax was high enough to raise enough money so it would be worth pissing off constituents, it would be too high to be legal. Some people might go as far as saying that Congress should concentrate on ways to spend less money, rather than try to squeeze more and more of it from people who don’t have any.

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